Individual
THERESIA LYNN TITUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
17978 SR 55, BAKER, WV 26801
(304) 897-5915
(304) 897-6216
Mailing address
1905 MICHAEL AVE, PETERSBURG, WV 26847-9460
(304) 290-5239
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2681
WV
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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